Screening for Cervical Cancer

What is the Pap test?

A Pap smear is a medical procedure in which a sample of cells from a woman’s cervix which is the end of the uterus that extends into the vagina, is collected and smeared on a microscope slide and are examined under a microscope in order to look for pre-malignant or malignant changes.

Sometimes it is simply called a Pap Test. It is a simple, quick, and relatively painless screening test. A few women develop cervical cancer despite having regular Pap screening. Even pregnant women can safely have a Pap smear. There are absolutely no known medical risks associated with Pap smear screening.

What about the results?

The Pap smear is not intended to detect other forms of cancer such as those of the ovary, vagina, or uterus. Cancer of these organs may be discovered during the course of the gynecologic exam, which usually is done at the same time as the Pap smear.

The human papilloma virus (HPV), or more commonly known as the genital warts virus is the major cause of abnormal Pap smear results, but most women with HPV infection do not get cervical cancer. About 95-100% of cervical cancers have signs of HPV infection on sophisticated testing.

Abnormal smear results

Some women are more likely to have abnormal Pap smears than other women. One common cause of abnormal Pap smears is smoking. Many women do not realize that smoking is strongly linked to cervical cancer. Smoking increased the risk of cervical cancer about 2- to 4-fold. Women who became sexually active at a very young age can may have risk for abnormal Pap testing, although this factor is less significant.

Information included on a Pap smear report includes the following: the name of the woman, the name of pathologist and the cytotechnologist who read the smear, the source of the specimen (which is the cervix) and the date of the last menstrual period. It also includes the woman’s menstrual status, medical history, number of slides, the description of specimen adequacy, diagnosis and recommendations.

An abnormal Pap smear is one in which the laboratory interprets the cellular changes to be different from those normally seen on a healthy cervix. There are a number of possible follow-up scenarios for an abnormal Pap smear.

Women who are at highest risk for abnormal Pap smear testing are those who are not getting regular Pap testing. Therefore, it follows that in order to improve overall Pap smear screening, women who are not getting regular Pap smears should be educated about and offered Pap testing. These under-served women should be the most heavily targeted for Pap screening.